“Recognize and remove” is key to detecting, managing concussions among youth, say new guidelines for parents and coaches

BUFFALO, N.Y. – Researchers around the world, including internationally known concussion expert John J. Leddy, MD, clinical professor of orthopaedics and sports medicine in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, have developed an easy-to-follow guide so parents and coaches can recognize concussions in young athletes and respond appropriately.

“Concussion Recognition: A Guide for Parents and Coaches,” which was published Nov. 5 in the Archives of Physical Medicine and Rehabilitation and which is publicly available, was developed in response to concerns that because qualified athletic trainers aren’t always on hand at youth sporting events, coaches and parents should know the signs of concussion and what to do if they see them.

‘Recognize and remove’

The bottom line is “recognize and remove,” the authors say. Evidence shows that earlier recognition and removal of the athlete is correlated with a quicker return to competition.

“So if you're telling parents that you can reduce your child's recovery time by half, that's probably pretty good motivation to remove them and get them into a health care provider as quick as possible,” says Leddy, who is also director of the Concussion Management and Research Center at UBMD Orthopaedics and Sports Medicine.

“They don’t have to diagnose it,” he says. “They just have to suspect it. If they suspect it, then the advice is to take that athlete out of the sport, remove him or her from further risk, and get them seen by a medical professional who knows how to evaluate this condition.”

Lead author Ruairi Connolly, MD, a physiatrist at Cork University Hospital in Ireland, said that while the article is based on two leading scientific documents in the field, the team purposely wrote the guide using accessible language. They collected feedback on the wording in their draft from coaches and parents before the article was published.

The article includes a QR code that links to a two-page “Concussion Recognition Tool” that can be used by non-medically trained individuals to identify and manage a suspected concussion.

Designating a parent

Co-author Jennifer Wethe, PhD, former director of the Mayo Clinic Arizona Concussion Program, suggested that parents adopt a “safety officer model” in which there is a designated parent who knows what to look for. 

“Coaches are very busy. Getting this into the hands of motivated parents is how I think this information can make it to the grassroots level,” she says. “Don’t underestimate the power of highly motivated parents who are concerned about something like this. I see a lot of explaining away injuries unless there is something very specific to follow. Parents and coaches need a protocol, something they can go through step by step.”

The researchers stress that concussions happen in many sports besides football. Wethe cited ice hockey, biking, soccer, volleyball — even cheer squad. Connolly noted rugby and something as simple as “someone falling over outside playing in the schoolyard.”

Jaclyn Stephens, PhD, co-author and Colorado State University associate professor and occupational therapist, emphasized that young women athletes also need to be considered, since some studies have shown a higher prevalence of concussion among female athletes, which may be related to differences in neck muscle strength. 

“If we only think about concussion as a professional football problem, we’re failing to consider female athletes,” she said.

Stephens and co-author Ann Guernon, PhD, an associate professor of speech-language pathology at Lewis University, recently co-chaired the Athlete Development and Sports Rehabilitation Networking Group for the American Congress of Rehabilitation Medicine. The researchers’ article is based on that definition of concussion/mild traumatic brain injury, as well as the 6th International Consensus Statement on Concussion in Sport.

In addition to Connolly, Guernon, Leddy, Stephens and Wethe, the authors represent a variety of fields, from physical therapists to medical doctors to neuropsychologists to speech therapists.